"Bulletproof skeptics in life's jungle": which self-exempting beliefs about smoking most predict lack of progression towards quitting?

Abstract

Objective: To determine the prevalence, correlates, and predictive value for intention to quit of 18 commonly expressed self-exempting beliefs about smoking among smokers and recent quitters, some 20 years after intensive tobacco control commenced in Australia.

Method: National telephone survey of randomly selected 802 adults (685 smokers; 117 recent quitters). Main outcome measures. Level of agreement or disagreement with 18 self-exempting beliefs about smoking and intention to quit.

Results: Four coherent categories of self-exempting beliefs are widely held by smokers ("bulletproof", "skeptic", "jungle", and "worth it"). Smokers who hold self-exempting beliefs are more likely to be aged over 50, smoke more than 15 cigarettes per day, have less than 12 years of schooling, and be in the precontemplation stage of change. All scales had some relationship with progress towards quitting. In particular, "worth it" beliefs are powerful independent predictors of smokers not planning to quit.

Conclusions: Some self-exempting beliefs seem to act as a shield for smokers, giving them false reassurance and allowing them to avoid thinking deeply about the importance of quitting. This is particularly true of "worth it" beliefs. The prevalence of such beliefs may suggest confusion about smoking being a risk rather than a probable cause of illness. Creative approaches to increasing the saliency of the costs of smoking may be fruitful.